Pre-Bolussing, For the Win

I was pretty slack around actually giving my insulin doses when I was on injections. I would often find myself giving insulin after I had eaten dinner, simply because I couldn’t be bothered getting up from the table to grab my pen and work out my insulin dose. Then there was the issue of having to dose again if I’d eaten more than I’d anticipated at dinner, so I opted to be lazy and bolus once after I had eaten my dinner.

This is one of the reasons why I absolutely love having the insulin pump attached to me all the time. There really is no excuse not to be giving my insulin when I eat. Although this is not the reason I switched to an insulin pump, it does offer me a level of convenience that I simply did not have on injections.

Before the pump, my daily insulin dosing was full of lousy guesstimates, which often left me going too low or too high after meals. Last month, I wrote about how the pump had given me an added focus on my carbohydrate counting, and I’m happy to report that I am still counting my carbs diligently today.

In the past couple of weeks, I’ve slipped into a really good morning routine that sees me pre-bolussing my breakfast insulin dose 15-30 minutes before I eat every day. Breakfast is probably the easiest meal to do this for, because my morning routine is almost identical each day. I usually deliver my insulin, sit and drink my coffee, go and get dressed and then come back and have my breakfast – usually a warm bowl of Oats or a slice of toast slathered with butter. Delaying the carbs until my insulin starts working usually helps to prevent my blood sugar from spiking too high after eating. I’ve been pleased with the results so far, and I’m hoping to make this a little more routine throughout the rest of the day.

Pre-bolussing also makes the prospect of higher GI foods such as whiter breads and pastries less daunting. They used to cause a lot of frustration in the aftermath, but nowadays I find that I am not so reluctant to treat myself if I wish to.

Another thing that makes me really happy these days is that I am actually using far less insulin compared to injections. This was really hard to believe when Gwen first told me on pump day, but it is so true. My insulin to carb ratio is much wider than the one I used on injections. My basal insulin provides precise coverage to match the time of the day, and my level of activity. With diligent carbohydrate counting, my insulin dosing is far more accurate. When I think about it, I am actually having far less highs and lows after meals as a direct result of my insulin dosing.

When I compare all of this to my life prior to the pump, I am working my butt off with my diabetes at the moment. I’m super proud that I am still so focussed after two and a half months on the pump, even through burnouts. I feel that I am well on track to seeing an improvement in my hba1c result at the end of the year.

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5 Comments

Ohhhh the dedication Frank! I still don’t prebolus on the pump because a lot of the time I only eat half of what I have on my plate and I would never remember to give half up front and half later. I think pre-bolusers are brave people.

[…] am happy to put the work into the carbohydrates I eat. As I wrote last week, pre-bolussing for meals helps me to avoid the post meal spikes. Carbohydrate counting does work when I’ve got my ratios […]

[…] In a recent blog post, I expressed that my insulin pump has offered a greater level of convenience in giving my insulin doses. I lamented that I was often slack with carbohydrate counting, weighing my portions and delivering insulin in a timely manner when I was on injections. This led to a few comments from social media trolls that accused me of getting an insulin pump because I was lazy. […]